Weverling G J, Stam J, ten Cate T J, van Crevel H
Afd. Neurologie, Academisch Medisch Centrum, Amsterdam.
Ned Tijdschr Geneeskd. 1996 Feb 24;140(8):440-3.
To determine the effect of computer-based medical teaching (CBMT) as a supplementary method to teach clinical problem-solving during the clerkship in neurology.
Randomized controlled blinded study.
Academic Medical Centre, Amsterdam, the Netherlands.
103 Students were assigned at random to a group with access to CBMT and a control group. CBMT consisted of 20 computer-simulated patients with neurological diseases, and was permanently available during five weeks to students in the CBMT group. The ability to recognize and solve neurological problems was assessed with two free-response tests, scored by two blinded observers.
The CBMT students scored significantly better on the test related to the CBMT cases (mean score 7.5 on a zero to 10 point scale; control group 6.2; p < 0.001). There was no significant difference on the control test not related to the problems practised with CBMT.
CBMT can be an effective method for teaching clinical problem-solving, when used as a supplementary teaching facility during a clinical clerkship. The increased ability to solve problems learned by CBMT had no demonstrable effect on the performance with other neurological problems.
确定基于计算机的医学教学（CBMT）作为一种辅助方法在神经病学实习期间教授临床问题解决能力的效果。
随机对照双盲研究。
荷兰阿姆斯特丹学术医疗中心。
103名学生被随机分配到可使用CBMT的组和对照组。CBMT由20个患有神经系统疾病的计算机模拟患者组成，在五周内CBMT组的学生可随时使用。通过两项自由应答测试评估识别和解决神经问题的能力，由两名盲法观察者评分。
CBMT组学生在与CBMT病例相关的测试中得分显著更高（在0至10分的量表上平均得分为7.5分；对照组为6.2分；p<0.001）。在与CBMT练习的问题无关的对照测试中没有显著差异。
当CBMT作为临床实习期间的辅助教学工具时，它可以是一种教授临床问题解决能力的有效方法。通过CBMT学到的解决问题能力的提高对解决其他神经问题的表现没有明显影响。
